Why is Thyroid so under treated?

Doctor: “My hair is falling out”; “I’m cold all the time”; “I’m so tired and fatigued, I want to take a
nap at 3:00 in the afternoon”; “My
skin is dry”; “My fingernails are
cracking”; “I can’t think straight”.
How many of you experience some of these symptoms or know someone who
does?? These are symptoms of thyroid
insufficiency. And all too often this condition goes undiagnosed and untreated. So many people suffer from symptoms like
these and these symptoms can be alleviated.
But, all to commonly, they are just overlooked and neglected by far too
many everyday doctors. Why? Because too many doctors rely on blood tests
rather than listening to and understanding the patient.

I remember
early in Medical School. I was in a
class on physical diagnosis and my professors made it perfectly clear: “listen to the patient and he will tell you
want is wrong. Labs tests are for
confirmation and monitoring of the diagnosis and should not be solely relied
upon to make the diagnosis”. Where
did the medical profession go wrong? All
too often these days, the opposite happens: look at the lab test and then tell
the patient the diagnosis.

The
condition in which this conundrum happens most frequently is “hypothyroidism”. It is true, the “classic” definition of
hypothyroidism is a collection of typical thyroid symptoms AND an abnormal
blood test. The blood test in question
is called TSH (Thyroid Stimulating Hormone).
TSH is produced by the pituitary gland (a small pea sized gland located
in the brain, often called the ‘master gland’).
When thyroid hormones (triiodothyronine – T3 and Thyroxine – T4)
decrease in amount, the pituitary senses this and will produce more TSH to
signal the thyroid gland to produce more thyroid hormones. So, in “classic” hypothyroidism (low thyroid)
the TSH level rises as the pituitary gland signals the thyroid to produce
more. The opposite is true in
hyperthyroidism. When the thyroid is
overactive, the excess amounts of thyroid hormone influence the pituitary to
produce less TSH and thereby lower the influence on the thyroid gland to
produce T4 and T3. However, the actual
appearance of true hypothyroid is far lower than the number of patients
presenting today with hypothyroid symptoms and NORMAL thyroid levels. These poor patients are suffering, and many
traditional doctors are simply overlooking them and not treating them
adequately.

Why does
this happen?

There are several
reasons for this. Time and insurance
pressures are causing doctors to improperly rely more and more on blood tests
to diagnose and treat patients. As a
result, despite the high degree of symptoms, patients with “normal” blood
levels are not treated for symptoms of low thyroid. In fact, even the American Academy of Clinical
Endocrinology practice guidelines state that otherwise normal patients with
“normal” levels of TSH should not be treated for hypothyroidism. The clinical application of such a “strict’
guideline, many times, leaves patients with uncomfortable and sometimes
debilitating symptoms. Endocrinologists
will insist that the symptoms are due to something else. Just what that “something else” is often
remains elusive or is something that “your primary doctor should investigate”

In actual
practice and from my experience with hundreds of patients with low thyroid
symptoms, treating symptoms will result in more healthy and vital
patients. And there is substantial
medical evidence for this. I refer to a
paper published in 2012 by the National Academy of Hypothyroidism. That paper stated “it becomes clear that
standard blood tests, including the TSH and T4 levels, cannot be used to
accurately determine … thyroid level in the presence of a wide range of common
conditions, including … dieting, anxiety, stress, insulin resistance, obesity,
diabetes, depression and bipolar disorder, hyperlipidemia (high cholesterol and
triglycerides), chronic fatigue syndrome, fibromyalgia, neurodegenerative
diseases (Alzheimer’s, Parkinson’s and multiple sclerosis), migraines, cardiomyopathy,
and aging” further “the pituitary has different [response to thyroid hormone]
than every other tissue in the body; the thyroid [response by other tissues in
the body is] affected by numerous conditions while the pituitary is minimally
affected.

What this
means is that the symptoms a person feels regarding thyroid depend on so many
different factors; that simply measuring a blood level that reflects the
pituitary response may not tell the entire story in the patient as a
whole. Going back to my medical school
directive: Patient’s must be asked how they feel and what symptoms they are
having and then a preliminary diagnosis can be made. Once the diagnosis is
presumed, the blood work should be properly used to monitor the results of
treatment as long as the blood levels are carefully coordinated with the
patient’s clinical response and not used in lieu of the patient’s symptoms.

While
patient’s with thyroid symptoms and normal levels of thyroid hormones do not
technically have “hypothyroidism”, the medical literature clearly makes the
point that using thyroid as an “off label” supplement can reduce their
symptoms, improve their physiology, aid their well-being and substantially
improve their quality of life.

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About

Dr. John Carrozzella is a Diplomat of the American Board of Anti-Aging and Regenerative Medicine. He is an expert in Bio-identical Hormone Replacement Therapy, Sexual Dysfunction and the Metabolic and Nutritional Treatment of Disease. He has practiced medicine and surgery for more than 25 years. More recently, he has focused his interests in the medical specialties of Innovative Wellness, Anti-Aging, Bio-identical Hormone Replacement, Integrative and Functional Medicine and Non-surgical Cosmetics.